Submitted to Popular Rationalism by Hooman Noorchasm, MD, PhD
(Feb. 23, 2025) — President Trump’s most precise tool for recovering US taxpayer dollars lost to fraud in the healthcare arena is President Abraham Lincoln’s Civil War-era law, known as “The Lincoln Law”—today, the False Claims Act. Instead of an indiscriminate chainsaw, Mr. Trump would be well served to unleash the full force of the False Claims Act in the healthcare space.
The Trump administration aims to limit fraud, misuse, and abuse of taxpayer dollars by the federal administrative state. The administration been determined that a major source of loss in the federal government is an inefficient and bloated federal bureaucracy. This idea is almost certainly correct in some quarters of the US federal bureaucracy. But a “one-size-fits-all” approach to the indiscriminate dismissal of thousands of federal employees is likely inefficient and potentially damaging to fixing the problem.
The primary source of the problem of waste and abuse caused by the federal administrative state is not intrinsic to the design or original purpose of the federal bureaucracy. Instead, the root cause is that an unacceptably large fraction of our federal government’s administrative state is now captured by industry actors — from elected officials serving in Congress to appointed bureaucrats in charge of executive branch agencies. The legal and political source of this government captured by industry is another topic — but simply put, when the large corporate sector, not the people, rules dominantly over US government agencies and personnel, citizens get shortchanged, robbed, or harmed. I believe that President Trump’s rise to unprecedented populist influence is directly related to the increasing disenfranchisement of American democracy from the machinations of the U.S. government and its industry partners and experts. When industry captures the US flag for profit alone, without regard for people’s safety and well-being, democracy rises in populist outrage — and rightly so.
This ongoing corporate capture of the U.S. administrative state has created a biased, pro-industry, and, in many cases, anti-citizen administrative state prone to waste and perpetuation of fraud for profit’s sake—robbing the U.S. Treasury of taxpayer dollars and exposing unsuspecting American citizens to harm.
No place is this type of federally enabled fraud more rampant than in the healthcare sector today – wherein not only are taxpayers’ Medicare/Medicaid dollars susceptible to abuse but American patients’ very safety and lives are at stake.
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Dr. Noorchasm is basically right about his point. But he did not develop it enough. A good place to start in order to identify how corrupted our regulatory system for healthcare has become is retracted papers. Bureaucratic decisions are supposed to be based on some form of objective knowledge. This assumption is the heart of the administrative state as conceived by Woodrow Wilson. Fill the federal government with technical specialists for the areas of regulation. What Wilson failed to anticipate is that the knowledge needed for regulation resides in the industries to be regulated. Who would regulate railroads other than people who know railroads in depth and detail? Same for oil, drug manufacturing, etc.
If we use drug products as an example, of course we have to turn to the prodigious drug research community. They are constantly doing research and cranking out thousands upon thousands of studies on a monthly basis. There is supposed to be this little thing called peer-review. Done right, it is critical thinking at its finest. Done wrong and we get the kind of crap that was published especially during Covid.
There is still a book to be written about the institutional deceit that shaped publishing decisions in healthcare. I will never forget the video showing members an FDA advisory board charged with voting on whether or not to give children the mRNA vax. It could not have been more obvious that safety had NOT been established. Yet, there was the editor in chief of the New England Journal of Medicine himself saying we have to try it. Children were least affected by Covid, yet he stared into the camera asserting they must get this dangerous product. And there was no one to stop him from this insanity. No One. Something has to change.
So, to Dr. Noorchasm’s point, a clear distinction needs to be drawn between what works and what does not work. Covid gave us plenty of examples how to do it wrong. I pray we establish the standards, practices and even the swift and decisive consequences that prevent that from ever, ever, happening again.